New benefit claimants with a learning disability are now most likely to have to claim universal credit, a means-tested benefit, to maximise their income.
Universal credit claimants with a disability or illness that affects their ability to work should always ask for an assessment to determine if they have limited capability for work-related activity (LCWRA) and/or limited capability for work (LCW).
This is assessed via the work capability assessment (WCA). Claimants who are found through the WCA to have LCWRA will be paid extra money.
Being found to have (or not have) either LCW or LCWRA also determines whether there are responsibilities the claimant must fulfil while getting the benefit, and the nature of those responsibilities. These are outlined in a (claimant commitment).
Clients should follow the relevant steps early in their claim for universal credit to obtain their LCW/LCWRA status.
Prioritise a doctor’s note
In the initial universal credit application form, people can state whether they have a health condition or disability that affects their ability to work.
It is also crucial that the client obtains a medical certificate, called a fit note, from their doctor as soon as possible. This should state that their patient is not currently able to work.
This can then be uploaded to the claimant’s universal credit account. The claimant (or their support worker/adviser) should also place a note on their online universal credit journal (which all claimants have) to remind their job centre work coach that the WCA process should now be started.
The above is vital because the claimant cannot achieve their LCW/LCWRA status, and so potentially get extra money within their award, until the 14th week after they have submitted their fit note. (The previous 13 weeks is called the WCA assessment period.)
In addition, the claimant must keep providing fit notes that cover the assessment period until they get an outcome in their WCA.
During the assessment period, disabled people can be subject to work-related requirements, including having to seek work. The client should, however, ask their work coach to adjust their claimant commitment because of the limitations caused by their disability.
The work coach should initiate the WCA. The claimant will then be sent a form, the UC50 capability for work questionnaire, to complete. They must complete and return this, or they will be treated as being capable of work and will have to start the WCA process again to establish LCW/LCWRA status.
If the decision maker at the Department for Work and Pensions believes there is enough information in the UC50 and in other documents (e.g., medical evidence), they can make a decision on the claimant’s LCW/LCWRA.
However, it is more likely the person will be referred for a face-to-face assessment with an independent healthcare professional. Historically, this usually took place in person, but now can also be done over a video call or telephone.
Following this assessment, the healthcare professional will write a report about the clients abilities concerning the WCA activities. The DWP decision-maker will come to a conclusion based on this and other evidence. The decision and related financial implications will be one of the following:
The client has limited capability for work and for work-related activity. The claimant cannot work now and is not expected to prepare for work in the future. They will get the LCWRA element included in their award, worth Ł343.63 per month. This is backdated to the 14th week after they first provided a fit note.
The person has limited capability for work. The claimant cannot work now, but can prepare to work in the future, e.g. by writing a CV. If the client is claiming for the first time, they will not get the LCW element as it was abolished for new claimants in 2017.
The claimant is fit for work and has to carry on claiming universal credit as a jobseeker. They will get the standard allowance and, like other claimants, may be entitled to additional money e.g., for children, childcare and housing costs.
There is a right to ask for the decision to be reconsidered as well as to appeal against it. There is a very high success rate in appeals regarding the WCA, especially where the client is represented.
Moving from an older benefit
It is important to remember that the situation is different for clients who are claiming certain legacy benefits such as income-related employment support allowance who have to migrate to universal credit, for example because of a relevant change in circumstances.
If they have current LCW/LCWRA status from another benefit, this is retained in their universal credit award. They will continue to get their LCWRA or LCW element if applicable. Migration to the benefit should not trigger a fresh WCA.
Several aspects of universal credit make it a tricky benefit for clients to manage. Establishing limited capability for work is a very important part of the claim process, and clients and advisers need to be proactive in making sure this is done promptly and correctly.
